Lamivudine prophylaxis for hepatitis B virus infection after lung transplantation
Ariella Bar-Gil Shitrit1, Mordechai R Kramer, Ilana Bakal
1Gastroenterological Department, Shaare Zedek Medical Center, Jerusalem, Israel.
The Annals of Thoracic Surgery
|April 25, 2006
Summary
Prophylactic lamivudine is safe for lung transplant recipients at risk of hepatitis B virus (HBV) infection. While generally effective, two patients experienced reactivation, one with a resistant strain, highlighting the need for careful monitoring post-transplant.
Area of Science:
- Hepatology
- Transplant Surgery
- Virology
Background:
- Hepatitis B virus (HBV) infection poses a risk in organ transplantation.
- Lamivudine prophylaxis is established for liver and renal transplants but not lung transplants.
- Limited data exists on lamivudine's efficacy and safety in lung transplant recipients.
Purpose of the Study:
- To evaluate the safety and efficacy of prophylactic lamivudine treatment in lung transplant recipients.
- To assess outcomes in patients with pre-existing HBV infection or those receiving organs from HBc antibody-positive donors.
Main Methods:
- Routine screening for HBV markers in 120 lung transplant recipients and donors.
- Prophylactic lamivudine treatment for 12 months in eligible recipients.
- Monitoring of liver function, HBV serology, and HBV-DNA levels during follow-up.
Main Results:
- Eleven recipients (9.2%) received lamivudine prophylaxis.
- No side effects were reported; median follow-up was 24 months.
- Two patients experienced HBV reactivation with elevated liver enzymes and HBV-DNA; one developed a lamivudine-resistant strain.
Conclusions:
- Lamivudine is considered safe for HBV suppression in lung transplant recipients.
- Careful monitoring is essential due to potential for reactivation and resistance.
- Further research may be warranted to optimize prophylaxis strategies.
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